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Sleep issues are common during pregnancy. Certain positions may help a pregnant person’s sleep quality. Sleep aids may also be useful for some.

A National Sleep Foundation survey found that 78% of women have more trouble sleeping when pregnant, with 15% experiencing restless leg syndrome during the third trimester.

Many women report fatigue during pregnancy, particularly in the first and third trimesters. Rising progesterone levels and the effort of carrying around extra weight can intensify this fatigue, which sleep deprivation can worsen.

Some strategies can help pregnant women get better sleep. In this article, we look at sleeping positions to try or avoid and discuss sleep aids that are safe to use during pregnancy.

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Placing a pillow between the legs when sleeping may help with back pain.

During the first trimester, it is safe for a woman to sleep in whatever position she feels comfortable in, whether this is on her back, side, or stomach. Any combination of the above positions is also fine.

The uterus has not grown large enough to interfere with sleep. However, hormonal changes, nighttime hunger, nausea, and other pregnancy symptoms may make sleep more difficult.

As a woman reaches the second and third trimesters, it is ideal to sleep on the left side. Being in this position maximizes blood flow to the uterus without putting pressure on the liver. Women who experience hip or back pain during pregnancy may find that placing a pillow or two between the knees or bending the knees during sleep can help provide relief.

A woman who prefers to sleep on her right side can adopt this position instead. There is no research showing that this is dangerous.

Some other sleep positions that may help resolve common issues include:

  • raising the upper body with a few pillows to reduce heartburn
  • elevating the legs with pillows to help with swelling and leg pain
  • using a body pillow or pregnancy pillow to cradle the body and provide additional back support

Experts consider some sleeping positions to be less advisable than sleeping on the side. These include:

Stomach sleeping

Many pregnant women worry that sleeping on their stomach will harm the developing fetus. However, the uterus protects the fetus well, and there is no reason to avoid sleeping on the stomach during the first trimester.

As pregnancy progresses, most women find that sleeping on the stomach becomes impossible or difficult.

For women who still prefer stomach sleeping or who occasionally wake up on their front, there is no need to worry. Sleeping on the stomach will not harm the baby.

Some pregnant women may find that using several sleeping pillows allows them to sleep on their stomach. It is fine to use these devices and perfectly safe to wake up lying on the stomach.

Back sleeping

In the third trimester — from the 28th week of pregnancy onward — sleeping on the back puts pressure on the main blood vessels that deliver blood to the uterus. This pressure may decrease the oxygen supply to the fetus. It can also increase unpleasant symptoms, such as dizziness and heartburn, in the woman.

A 2019 study links ongoing back sleeping during pregnancy to an increased risk of stillbirth. Other studies have arrived at similar conclusions.

However, this study looked at the position in which a woman fell asleep rather than the position she moved into during sleep. There is little evidence that accidentally rolling onto the back during pregnancy will cause lasting harm. As a result, not all experts agree with the advice to avoid sleeping on the back.

A 2018 University of Utah interview with three high risk pregnancy specialists emphasizes that one study linking back sleeping to stillbirth did not control for other factors. The specialists also note that even in women who sleep on their backs, the risk of stillbirth remains low.

A woman who is concerned that she frequently awakens on her back can try using pillows to support her body and help her remain on her side.

Resources for healthy sleep

To discover more evidence-based information and resources on the science of healthy sleep, visit our dedicated hub.

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Different strategies can help a pregnant woman sleep better. Women finding it difficult to sleep can try:

  • Asking a doctor to test for vitamin deficiencies. Folic acid or iron can sometimes treat restless leg syndrome (RLS). It is important to consult a healthcare professional before taking supplements to treat any condition.
  • Elevating the torso and head to reduce heartburn. Some women find relief by sleeping in a semi-sitting position, such as lying on the side in a reclining chair.
  • Trying pregnancy pillows. Many different types of pillow are available for purchase online.
  • Eating a small meal before bed. Particularly during the first trimester, some women wake up very hungry. Protein-rich food can reduce appetite, so eating foods such as nuts, fish, peanut butter, and meat before going to sleep may help a woman feel satiated.
  • Eating smaller and less fatty meals to reduce heartburn.
  • Taking an antacid. Over-the-counter (OTC) antacids are safe during pregnancy, but it is important to consult a doctor before taking any medication, including OTC drugs.
  • Talking to a doctor about snoring. Severe snoring can make it difficult to breathe during pregnancy.

Learn other tips on how to improve sleep quality here.

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A woman can talk to her doctor if she is having ongoing sleep difficulties.

Women who do not get quality sleep during pregnancy may experience physical and emotional fatigue. This fatigue can make it difficult to work, go to school, or accomplish daily tasks.

Some research suggests that a lack of sleep can also lead to mood disorders, such as depression, and potentially result in negative pregnancy outcomes, such as growth restriction of the fetus and preeclampsia. It can also cause secondary problems, such as fatigue-related accidents.

If a woman is experiencing ongoing difficulties with sleep during pregnancy, she should speak to a doctor about how to improve her sleep.

Sleep can prove challenging at every stage of pregnancy. While there are no perfect solutions, various strategies can help with pregnancy-related sleep difficulties.

Women can try a range of techniques to improve their sleep quality and help ensure that they are sleeping in a position that is safe for the developing baby’s health and their own.

A doctor can offer advice if a pregnant woman is struggling to get enough sleep or is sleeping in excess.